What is it Like to Have Your Book Reviewed by the New York Times?

It's an exciting day when your book is finally released, and you read about it in the New York Times.  Sure, the review could be bad, but if you are on a roll and things are really going your way, then it will be a good one!

I asked psychologist Joe Nowinski what it was like when his new book, Saying Goodbye: How Families Can Find Renewal Through Loss was featured in the New York Times.  Joe said, "Having our book review appear in both the online and print editions of the New York Times is a landmark experience for me."  He went on to say that becoming a blogger for the Huffington Post—a result of publishing Saying Goodbye—is also a "dream come true." 

Joe co-wrote Saying Goodbye with another psychologist (and colleague of mine at Harvard Medical School), Barbara Okun.  He says, "There is no doubt that Barbara Okun and I poured our hearts and soulds into Saying Goodbye, but this kind of response is incredibly rewarding for our efforts."

When I mentor physician-writers, I always encourage them to write about things that are really meaningful to them.  After all, hopefully you'll be interviewed extensively on the topic, and it's always best if you really are passionate about it.  Joe and Barbara wrote about what they coined "new grief."  The kind of grief that ensues when people with terminal diagnoses have months or even years to live, because medical science is getting better and better.

Joe told me, "The need to come up with a new paradigm for understanding how grief has changed has immense and direct application to my clinical work."  Interestingly, he has found that the principles in new grief are helpful in other situations such as divorce.

A book review in the New York Times is a wonderful announcement to the world about a subject that you feel passionately about.  A rare and wonderful accomplishment and a day to savor forever!

We Need Effective Physician Leadership

Where's the rank and file physician leadership? The Story Behind the Story

The New York Times recently ran a front page story about the Senate Finance Committee's ongoing investigation of an interventional cardiologist in the Baltimore area. This cardiologist, among other allegations, is being questioned about the appropriateness of inserting 30 intracardiac stents in a single day. THIRTY STENTS IN A DAY!!!!

In their investigation the Finance Committee has discovered evidence that many of this physician's procedures were not medically necessary...DUH!

But wait, this soap opera is not over. It turns out that this interventionalist was recruited by the hospital in which he worked, from the group he himself founded by a seven figure salary. His premium salary apparently was not based on superior medical judgement. But this lurid card was trumped by the president-elect of the Society of Cardiovascular Angiography and Intervention. When asked for a comment from the Times, he responded that "inappropriate stenting was a problem, but a rare one". The 3.6 billion bucks a year Medicare spends on stenting does not stop on his desk.

This story is really a story about the total ineffectiveness of today's medical leadership. Where was the CMO, VPMA, Director of Cardiology, and Cath Lab Director during this eveloving scandal. Who was safegaurding the quality of care delivered? Why was the behavior of this "cowboy" not addressed by them insead of the Federal Government, The New York times and some soon to be wealthier ambulance chasers?

Why didn't the president-elect of SCAI make the following statement to the times? "The allegations, if true, are an outrage and are unacceptable. I will take personal responsibility to learn from this unfortunate episode and make sure we develop protocols that will assue this will not happen again".

We need to invest in the training of physician leaders who embrace accountability and transparency, who are committed to consistent and demonstrable excellence in healthcare delivery, and most importantly master the skill set to be effective.

The consequences of our failure to train such leaders will be further loss of public confidence, more external regulation and review, wealthier personal injury lawyers supported by increases in our malpractice premiums and, most tragically, inconsistent suboptimal outcomes for our patients.